Age 49 & loose skin under eyes - cheek filler or lower eyelid surgery? (Photos)

From your photos it appears you have a few options to improve the area under your eyes. Blepharoplasty which you mentioned will remove excess skin and correct eye bags. Fillers can help improve volume loss under the eye and the cheek area. Another option is AccuTite which uses RF technology to tighten skin and improve under eye bag appearance. Results can be optimized by adding Morpheus8 treatments to improve overall skin tone and texture.

Thank you for your question and for showing your pictures, @Jacquiw383. You are a candidate for an eyelid surgery. You may have a lower blepharoplasty to remove the bulging of your eyes in this area. Additionally, I recommend upper blepharoplasty to improve the proportion of excess skin in the upper eyelid, without neglecting treatments that improve the quality of the skin and fine lines, so you can have an effective process to rejuvenate the appearance. The second and third thirds of the face can be improved by radiesse cheek rejuvenation. There is no need to choose since they both act in different places. Best wishes! Alan Gonzalez MD, FACS

A photo is not an adequate substitute for an in person exam. Loose skin can often be excised with a lower blepharoplasty. If the issue has to do with skin quality, topicals (such as retinols), chemical peels, IPL, or lasers may work well with the botox you are currently receiving. Be well!